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October 7, 2005

Hodgkin’s survivors at risk for breast cancer

by Sam Savage

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Due to the chest radiation that
is often given for treatment, women who survive Hodgkin's
disease are at heightened risk for breast cancer. In fact, in
some survivors, the odds of developing breast cancer are as
high as 40 percent, new research indicates.

The authors warn, however, that the findings are based on
older treatment approaches and, therefore, may not be
applicable to women treated today for Hodgkin's disease, a type
of cancer that affects the lymph nodes and organs involved in
the body's immune system.

"This study is the first, to our knowledge, to estimate the
cumulative absolute risk of breast cancer among women treated
for Hodgkin's disease at age 30 years or younger using detailed
information on radiation and chemotherapy," lead author Dr.
Lois B. Travis, from the National Cancer Institute in Bethesda,
Maryland, told Reuters Health.

The findings, which appear in the Journal of the National
Cancer Institute, are based on a study of 3,817 young women who
survived at least 1 year after being diagnosed with Hodgkin's
disease between 1965 and 1994.

The risk of breast cancer increased as age at diagnosis,
radiation dose, and duration of follow-up increased. The risks
ranged from 0 percent for a patient diagnosed at 15 years of
age, treated with a limited dose of radiation, and followed for
10 years to 40 percent for someone diagnosed at 30 years of
age, treated with a large dose of radiation, and followed for
30 years.

"Our results provide Hodgkin's patients with an estimate of
absolute breast cancer risk, particularly for those treated
with wide-field chest radiotherapy that was commonly used from
1965 to 1994," Travis said. The findings "should be used with
caution in patients treated with more recent approaches."

Travis said her group "is now updating the follow-up of
40,000 Hodgkin's survivors reported to international...cancer
registries" to examine the risk of other cancers in this group.